Disparities in assessments of asthma control between children, parents, and physicians

Shefer, Galit; Donchin, Milka; Manor, Orly; Levy-Hevroni, Revital; Schechter, Abraham; Cohen, Rinat; Cohen, Herman Avner; Kerem, Eitan; Engelhard, Dan

doi:10.1002/ppul.22924

Cited by 22 publications

(28 citation statements)

References 49 publications

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“…However, in children under age 6, a difficulty for understanding abstract concepts related to emotional or social limitations is reported . Secondly, the drawback of time‐consuming, given by the large number of items, might limit their usefulness in daily clinical practice by physicians .…”

Section: Discussionmentioning

confidence: 99%

Development of a nomogram to estimate the quality of life in asthmatic children using the Childhood Asthma Control Test

Montalbano

Cilluffo

Gentile

et al. 2016

Pediatric Allergy Immunology

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Background: Pediatric Asthma Quality of Life Questionnaire (PAQLQ) provides detailed information on QoL in asthmatic children, whereas Childhood Asthma Control Test (C-ACT) Questionnaire is the most validated instrument for asthma control. No study assessed the relationship between C-ACT and QoL in children by means of those instruments. The aim of this study was to determine whether a QoL estimation is possible using the C-ACT questionnaire in asthmatic children. Methods: Medical history, spirometry, C-ACT, and PAQLQ were assessed in 144 (60% male) outpatient asthmatic children from September 2011 to November 2014. A generalized linear model (GLM) for the prediction of PAQLQ was obtained through a stepwise procedure starting from a full model with all C-ACT items, and predictive nomograms were created. Results: Fifty-five (38%) well-controlled (WC) asthma, 37 (26%) partially controlled (PC) asthma, and 52 (36%) uncontrolled asthma (UA) patients were enrolled. Persistent asthmatics (PA) were significantly more uncontrolled (p < 0.0001). A significant reduction in FEV 1 , FEV 1 /FVC, and FEF 25-75 (p = 0.005, p < 0.0001, and p < 0.001, respectively) was found in WC vs. UA. Through a stepwise process, a reduced model showed a positive relationship between the PAQLQ and the four items of C-ACT. The regression equations for predicted PAQLQ were ln (PAQLQ) = 1.17 + 0.05*C-ACT2 + 0.03*C-ACT3 + 0.04*C-ACT6 + 0.03*C-ACT7. Thus, a nomogram was constructed. Conclusion:The designed nomogram provides a highly predictive assessment of QoL in individual patients, facilitating a more comprehensive assessment of asthmatic children in usual clinical care.

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Section: Discussionmentioning

confidence: 99%

Development of a nomogram to estimate the quality of life in asthmatic children using the Childhood Asthma Control Test

Montalbano

Cilluffo

Gentile

et al. 2016

Pediatric Allergy Immunology

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“…Finalmente es importante mencionar que si bien el ACT es un instrumento valioso en el manejo del niño asmático, no necesariamente existe una correlación entre la apreciación que tiene el paciente y/o sus padres de su enfermedad, contrastada con la opinión del pediatra o neumólogo pediatra, hecho que se describió con el cuestionario para niños de 4 a 11 años de edad (35) .…”

Section: Discussionunclassified

Traqueotomía en una unidad de tercer nivel del noroeste de México: descripción y análisis de casos

et al. 2017

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RESUMENObjetivo: Se realizó un estudio observacional, transversal y prospectivo, con el objeto de comparar el nivel de control del asma bronquial en pacientes pediátricos de 12 a 17 años de edad que acuden al Programa de Asma del Hospital III Yanahuara -EsSalud Arequipa con el nivel de control alcanzado en otros centros asistenciales de EsSalud Arequipa, utilizando como instrumento el "Asthma Control Test" (ACT) o "Test de Control del Asma" validado internacionalmente. Materiales y métodos: Se tomó una muestra de 60 pacientes distribuidos en 2 grupos: uno de ellos conformado por 30 pacientes que acuden al Programa de Asma en Pediatría del Hospital Yanahuara y otro por 30 pacientes que acuden a consulta ambulatoria de pediatría de otros centros asistenciales de EsSalud. Para fines del análisis se mantuvo la proporcionalidad en cuanto a sexo y severidad del asma entre ambos grupos. Resultados: El puntaje alcanzado mediante el ACT fue en promedio de 22,27 en el grupo que asiste al Programa de Asma del Hospital Yanahuara y 20,17 en los que asisten a consulta pediátrica general de otros centros asistenciales. El puntaje más frecuente fue de 25 en el primer grupo y 23 en el otro. Más de la mitad de los pacientes de ambos grupos alcanzaron un puntaje aceptable de control de la enfermedad; sin embargo, el "control total" se logró en mayor proporción en los pacientes que asisten a un programa preventivo (26,67% versus 6,67%) y el "pobre control" se observó en mayor proporción en niños evaluados en consulta ambulatoria de pediatría (36,66% versus 16,66%). Conclusiones: La gran mayoría de niños que asisten a un programa preventivo de control del asma logran un control total o aceptable con una diferencia estadísticamente significativa.Palabras clave: Asma; ACT; programa de asma.

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“…Engaging children more directly in the interview process and their care may improve information collection by the clinician, leading to a more accurate assessment of control [98,99], and also may help teach children to be more engaged in their healthcare from an early age. Engaging children more directly in the interview process and their care may improve information collection by the clinician, leading to a more accurate assessment of control [98,99], and also may help teach children to be more engaged in their healthcare from an early age.…”

Section: Proposed Role and Challenges Of Shared Decision-making In Pementioning

confidence: 99%

Shared clinician–patient decision-making about treatment of pediatric asthma

Rivera-Spoljaric

Halley

Wilson

2014

Current Opinion in Allergy &Amp; Clinical Immunology

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Disparities in assessments of asthma control between children, parents, and physicians

Abstract: In addition to increasing awareness of parents to symptoms in their asthmatic children, physicians should question the child appropriately, as well as using the children's responses to C-ACT as an information source for properly assessing asthma control.

Cited by 22 publications

References 49 publications

Development of a nomogram to estimate the quality of life in asthmatic children using the Childhood Asthma Control Test

Development of a nomogram to estimate the quality of life in asthmatic children using the Childhood Asthma Control Test

Traqueotomía en una unidad de tercer nivel del noroeste de México: descripción y análisis de casos

Shared clinician–patient decision-making about treatment of pediatric asthma

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